Articles Posted in Social Security Disability Insurance

Have you planned for a disability? Do you know what your rights are to public or private insurance? Public assistance and welfare programs are constantly under scrutiny for potential abuses and for “draining the system.” While there have certainly been cases of fraud or abuse, the majority of disability payouts go to individuals who have legitimately suffered in an accident, work injury, or who have suffered from a disease that leaves them unable to work. For many victims, seeking out benefits is a last resort.

In addition to Social Security Disability Income (SSD or SSDI) or Supplemental Security Income (SSI), private disability insurance is another option for individuals who are no longer able to work. Whether you are seeking benefits for yourself or a loved one, it is important to have a clear understanding of your rights and options regarding both public and private insurance benefits.

For millions of Americans, private disability insurance is not an option or the program will not cover the extent of costs after disability. Our Massachusetts Social Security Disability Insurance attorneys are dedicated to helping victims of disability and their loved ones collect benefits at the time of need. We are experienced in navigating the Social Security benefits system and in helping our clients quickly and effectively recover the financial support they need. We are also committed to keeping our community aware of disability benefits options to ensure that they have the financial assistance required in the event of an accident, unexpected disease or illness.

What is SSDI?
Social Security Disability (SSD or SSDI) is a federally funded insurance program managed by the Social Security Administration. The program provides income supplements to those who are unable to work because of a documented disability. Disability benefits can be supplied on a temporary or permanent basis and can be based on a physical or mental impairment. In addition to SSD, individuals may also be entitled to disability benefits from their employer or through a private insurance carrier.

How does SSDI impact private disability coverage?
According to the SSA, your ability to collect private insurance does not prohibit you from also collecting SSDI. Keep in mind that the amount you recover from pensions or private insurance could reduce the amount you collect through SSDI. If you collect workers’ compensation or are seeking SSDI coverage, remember that your total disability support cannot be more than 80% of your income before you were disabled.

According to the SSA, one in four 20-year-olds will be disabled and unable to work before they reach the age of 67. There were more than 650,000 disabled workers collecting long-term disability benefits through an employer-sponsored group in 2012. Private disability insurance has also been an asset to individuals who have lost their ability to work. In most cases, long-term disability is only 60% of a prior salary, requiring victims to adjust their lifestyle. However, for those who collect long-term disability, these payouts are often not enough to cover living expenses and medical bills.

If you have a private disability insurance plan and are considering applying for SSDI, providing documentation and understanding your rights is critical. As advocates, we are experiencing in reviewing benefits claims on a case-by-case basis to ensure that you get the maximum recovery you are entitled to.
Continue reading

A federal audit estimating some $1.3 billion in fraudulent over-payments by the Social Security Administration through its disability program is likely to result in more intensive scrutiny of new claims.

Our Boston SSDI attorneys are frustrated by this revelation because despite the news and widespread negative public perception of claimants, it is not easy for those who are legitimately ill to successfully obtain benefits. It is a long and arduous process, and many people – especially those who don’t have adequate representation from an SSDI attorney – end up falling through the cracks.
Continue reading

Serious workplace injuries are among the top reasons why people in Massachusetts seek Social Security Disability Insurance benefits.

A recent Social Security Administration report found that injuries were the sixth-leading cause of SSDI claims, and even those claims that don’t involve injuries are often job-related.

Now, our Boston SSDI claims attorneys understand that Allsup has conducted research to help determine what are the most dangerous states for workers and what jobs in particular are responsible for the most disability-causing injuries. The research is based on figures from the U.S. Department of Labor’s Bureau of Labor Statistics.

The findings reveal that there is a wide variation of workplace injury rates from state-to-state, even within the same industry.

As it turns out, Massachusetts is among the top five safest states in the country, tying at No. 3 with Alaska, Delaware, West Virginia and Wyoming, with a rate of 0.4 worker injuries or illnesses per 100 workers.

By contrast, Maine, deemed the most dangerous state in the nation, had a worker injury/illness rate of 1.4 per 100 workers.

There are no simple answers for the disparity, according to reporters are TIME, who indicate there is a convergence of relevant factors. For example, places like New York and D.C., which ranked safer on the list, tended to have more white collar, office-type jobs. Meanwhile, states like Maine and Louisiana, which both ranked high on the danger-meter, had large industries centered around historically treacherous industries like commercial fishing and oil services.

In looking at state-to-state variances within the same industry, there were some interesting results. For example, vehicle manufacturing in Tennessee resulted in a serious worker injury rate of 1.1 to 100 workers. Meanwhile in North Carolina, the serious worker injury rate for vehicle manufacturing was 3.5 to 100. For nurses in Maine, the serious injury/illness rate is 7.1 per 100, while the national average is 1.5 to 100.

This information is important because while a great deal of attention is paid to workplace fatalities, workplace injuries tend to go unnoticed. It’s estimated there are some 1 million U.S. workers annually who experience an injury that causes them to lose at least one day of work annually.

Learning how these injuries happen, how they are reported and how states and industries respond is important if we have any serious hope of driving down the increase in SSDI rolls.

While the national list of dangerous jobs ranges from amusement park worker (No. 1) to poultry and egg production (No. 10), the dangerous industry list for Massachusetts varies slightly.

According to a recent report by the Massachusetts Coalition for Occupational Safety and Health, the top five most dangerous jobs here are:

• Fire service;
• Construction;
• Fishing;
• Transportation;
• Tree care removal.

Continue reading

In this second of our two-part series on the common sources of shoulder pain and how they might impact your federal disability benefits claim, our Boston SSDI lawyers are looking at:

• Rotator Cuff Damage;
• Bursitis;
• Dislocated Shoulder;
• Frozen Shoulder.

This information offers a general idea of how claims involving these conditions may play out, but keep in mind that each case is fundamentally different. A decision about whether to file should only be made after careful consideration and review by an experienced disability attorney in New England.

That said, let’s start with rotator cuff damage. This is when the group of muscles and tendons that connect the arm to the shoulder are inflammed, bruised or strained. Usually, this is caused by performing some type of overhead activity or reaching behind your back. It’s a wear-and-tear type of injury, with about half of all 50-year-olds showing some kind of damage to their rotator cuff. Those who worked in construction, carpentry or athletics often have higher rates of injury.

Typically, the effects are minor and can be relieved with over-the-counter pain relievers, rest and sometimes physical therapy. Severe rotator cuff injuries may cause persistent pain and weakness in the shoulder.

There is no SSDI listing for rotator cuff injuries. Generally speaking, someone who is suffering from a rotator cuff injury probably won’t qualify for benefits, unless it is accompanied by some other condition that compounds it. SSDI Listing 1.02, which describes major dysfunction of a joint,
could apply if you can prove a total inability to perform fine and gross movements effectively.

The next kind of potential qualifying shoulder injury is bursitis. This is an inflammation of the bursa, or sacs of fluid that help to cushion the muscles, tendons and bones in a joint. These sacs serve to absorb shock and friction during movement. It’s usually recognized with a dull ache that worsens with certain types of movement, but infection – usually stemming from surgery – can amplify the pain. It’s one of the most common causes of shoulder pain, and if untreated, could cause a tear in the rotator cuff.

There is no specific listing for bursitis. However, if the condition is severe enough, you might be able to qualify for benefits under SSDI Listing 1.02. You would have to show joint dislocation or ankylosis and a significant limitation of movements in your arms.

Another common source of shoulder pain is a dislocated shoulder. Usually, this is caused from some type of trauma, such as a severe car accident or a fall. It’s also common for athletes. It’s usually fairly simple for doctors to move the arm back into the shoulder socket. While a person might be out of commission for a few weeks, with his or her arm in a sling, it probably won’t render you disabled long-term. The exception might be if you continue to suffer repeated dislocations, which tends to be more common with younger patients than with older patients.

Finally, the last most common source of shoulder pain is frozen shoulder. The clinical term is adhesive capsulitis. It is diagnosed when the connective tissue that lines the shoulder joint thickens and becomes inflamed. There are three stages of the condition, each with varying levels of pain, stiffness and movement ability. It tends to be more common in women older than 50 and those who suffer from thyroid diseases or diabetes, but the exact cause is unknown.

Doctors say that usually, it takes anywhere from 12 to 18 months to work through all the stages of the condition. SSDI requires that your condition last at least one year in order to qualify.

Sometimes physical therapy helps with frozen shoulder, but it is possible you may be rendered unable to work during that entire time. Consulting with an SSDI attorney early on following your diagnosis will help you determine what steps you need to take while the condition is ongoing.
Continue reading

Boston Red Sox Receiver Andrew Bailey has been ousted for the rest of the season, following a significant shoulder injury he suffered while pitching at a game in Oakland last month.

According to the Boston Globe, doctors have diagnosed him with a labrum tear, a tear in his capsule and a strained tendon.

Sports figures, from football players to professional boxers, are notorious for suffering injuries to their shoulders that render them unable to do their jobs. Unfortunately, our Boston Social Security Disability Insurance lawyers know they aren’t the only ones.

Shoulder injuries can range from mild to debilitating. However, whether such an injury will render you unable to work per the strict definitions outlined by the Social Security Administration is another matter altogether.

Because of the commonality of shoulder injuries, we are dedicating two entries to the kinds of shoulder injuries that occur the most frequently and which have the highest likelihood to qualify you for disability benefits.

Bear in mind that each case is going to be different. That means that while the extent of a shoulder injury may seem mild on the surface, factors such as one’s advanced age and limited work history and education could result in one being approved for benefits when he or she might not otherwise have been.

The AARP recently reported on the top five causes of shoulder pain. Some conditions may have one primary source of origin, while others may be the result of a combination of factors. The chances for disability approval for each will vary.

The first condition is Osteoarthritis. This is one of the most common forms of arthritis, and it’s typically diagnosed once the cartilage that protects the joints begins to wear down. In turn, this results in a chronic pain that many sufferers say worsens at night.

Those who have this condition describe joints that literally creak and click due to the loss of cushioning. Joints are weakened, stiff and sometimes appear swollen. Osteoarthritis is typically caused by wear-and-tear on the joints, and is often seen in individuals over the age of 50, who may be genetically predisposed to it. However, there have been instances in which a traumatic injury resulting in damage to the cartilage can cause this condition.

There is no cure for osteoarthritis, though in some instances, a combination of supplements may help to ease the symptoms. Pain relievers, physical therapy and modification of everyday movements to reduce joint stress are recommended before one considers surgery.

As far as disability benefits go, you might qualify for benefits under one of a series of back and joint problem SSDI listings. In rare cases, you may even qualify under a spinal disorder, if the condition has affected that region of your body too.

Generally speaking, disability examiners are going to be looking at whether your condition affects your overall ability to take part in the kinds of physical activity required for most occupations. These might include walking, sitting or standing for various periods of time. It could also mean examining your ability to lift, pull, push or grasp items, as well as your ability to occasionally stoop or bend.

Check back for Part II of this series to learn more about the primary causes of shoulder pain and how it correlates to your chances to receive federal disability benefits.
Continue reading

Singer Nick Cannon recently opened up about a bout of kidney failure he suffered last year that was diagnosed as stemming from a form of lupus.

In an interview with Rolling Out magazine, Cannon called the episode “crazy,” saying doctors were preparing for a possible 50/50 chance of survival and that the entire ordeal has given him a new perspective on life.

Our Boston Social Security Disability Insurance lawyers know that while many who suffer from lupus, an autoimmune disorder, are able to manage it, there are some cases so severe that they may render an individual unable to continue working. In these severe cases, SSDI benefits may be appropriate.

Lupus is a chronic inflammatory disease in which your body’s immune system turns and attacks your own organs and tissues. It can affect numerous body systems, including your kidneys, heart, lungs, brain, blood cells, skin and joints.

Usually, this is a tough condition to diagnose because the symptoms so often mirror other conditions. One of the most distinctive signs of lupus, a butterfly-like rash unfolding across both cheeks, doesn’t always occur in every case. Some people may be born with a tendency to develop the condition, but they might only realize it once they are exposed to certain drugs, infections or sometimes even excessive sunlight.

It’s estimated that 1.5 million Americans suffer from the disease. There is no known cure for the condition, but a lot of times it can be managed with anti-inflammatory drugs, immune suppressants and avoidance of certain triggers.

However, for some people, it’s not that easy and the condition refuses to significantly subside.

Section 14.02 of the SSDI blue book listings allow for disability benefits to be awarded to some of those suffering from lupus. In order to qualify under this listing, an individual has to meet the following requirements:

• Have a diagnosis of lupus that affects at least two body systems or organs, such as your lungs and kidneys or heart and brain;
• And the condition has to have caused at least two of the following symptoms: frequent exhaustion that brings on low mental or physical activity, fever, involuntary weight loss or malaise;
• Or you have to have repeated symptoms of lupus listed above that result in one of the following: limitations on daily living activities, limitations on social functioning or limitations with regard to completing tasks in a timely manner due to an inability to work quickly or focus. These limitations have to seriously interfere with your ability to function appropriately, effectively and independently.

Even if you don’t technically meet these requirements, you might still be able to qualify if you can prove that your health problems caused by lupus have rendered you unable to work. The administration is going to look at your residual functional capacity, or in other words your physical, mental and sensory limitations that could negatively impact your ability to work.

We are here to help.
Continue reading

Temporary workers represent a growing microcosm of our workforce, one in which workers have fewer protections, suffer more accidents, are less likely to have health care and face an uphill battle in securing any kind of workers’ compensation.

A recent expose by a team of journalists with TIME magazine and the non-profit ProPublica took a closer look at how corporations are more frequently utilizing these workers, typically to the detriment of full-time positions and the erosion of workplace safety.

As Boston Social Security Disability Insurance attorneys, we recognize that it’s highly unlikely that these workers have health care coverage, let alone long-term disability insurance. Yet they are more likely than full-time workers to get hurt on the job.

The majority of these individuals are production helpers, laborers and freight, stock and material movers, assemblers, packers, machine operators and construction laborers. These are fields that, by their very nature, tend to have higher rates of injury than other sectors of the workforce. Factor into this a lack of experience and on top of that a company’s lack of investment in that individual, and this will inevitably result in a higher injury rate.

Some of the examples have been horrific. In the winter of 2011, a temp worker in Chicago was killed after being scalded by citric acid solution at a shampoo and skin cream manufacturer. The factory never even called 911.

Then in mid-2012, a temp in Jacksonville was crushed to death his very first day on the job at a bottling plant when a supervisor instructed him to clean glass from underneath a stacking machine, a job that the Occupational Safety & Health Administration said he was not trained or qualified to conduct.

And then earlier this year, a temporary worker was killed at a paper mill in North Carolina when he was overcome by fumes while cleaning a chemical tank.

The government doesn’t keep a tally of how many temporary workers are hurt or killed on the job. However, a recent study out of Washington state revealed that temporary workers in the construction industry were twice as likely to be hurt while doing a job than a full-time staffer.

OSHA announced in April that it planned to launch an initiative to get better information on temporary worker injuries and safety protocol.

Based on ProPublica’s analysis of federal enforcement data regarding wage and hour violations, temp agencies consistently rank the worst. A 2005 survey by the U.S. Labor Department found that only about 4 percent of temps have retirement or pension plans from their employers. And about 8 percent get health insurance (compared to nearly 60 percent of full-time workers).

Massachusetts has established one of the better systems, with its Massachusetts Temporary Workers Right-to-Know-Law passed in January and said to be a model. IT requires that workers be told upfront who they will work for, how much they will be paid and what kind of safety equipment they will need. It also limits cost and fees for transportation to the job site, which tends to push wages below state and federal minimums.

Of course, this still doesn’t address the issue of how a worker will cope if he or she is injured on the job.

As we mentioned earlier, it may be tougher to secure workers’ compensation benefits if the individual has been hopping from one factory or construction site to the next.

This is where SSDI can be a critical lifeline. If you are rendered unable to work for more than a year due to an injury – whether work-related or not – you could be entitled to receive SSDI benefits.
Continue reading

Most people know that the first time they submit an application for Social Security Disability Insurance, there is a probability it will be rejected.

More than 60 percent aren’t going to get approved on their first try. What they may not realize is that beyond that point, there are many different levels of appeal, the last being federal district court.

Our Boston Social Security Disability Attorneys are prepared to fight for your claim every step of the way.

What’s encouraging to know is that with every step of the appeals process, your chances of being approved increases.

Consider that there are an average of 2.3 to 3.1 million federal disability applications each year. Of those, 69 percent go to the initial adjudication level (the rest are denied for technical reasons, usually missing paperwork or employment income is too high).

From that initial stage, just 38 percent are approved, while 62 percent are denied. Of those who are denied, 48 percent go onto appeal. At that appeal, a little less than 10 percent are approved. Of the 90 percent or so who are denied, only about 18 percent go forward through the disability process.

At that stage, which is before the appeals council, 81 percent are approved.

Now, if you are one of the approximately 20 percent still denied, you still have options.

Here’s what you need to know about that:

• You will have exactly 60 days from the time of that last decision during which to appeal. This will mean the filing of a civil complaint with the U.S. District Court in your area. This is something for which you should rely on your attorney.
• Technically according to federal law, you can’t directly sue the Social Security Administration. It will be whoever is the current or acting commissioner of the agency.
• Understand that the administration can not help you out with this. You are suing them. Know that the rules of federal court can be complex and unforgiving. Having an attorney who is experienced is critical, especially because most people have never gone through this process before.

After your appeal has been submitted, the court will issue a summons. Either you or your attorney is going to have to serve that summons on the administration at one of its designated field offices. At that point, the administration’s attorney files an answer, which is basically a short explanation of why the agency denied your claim.

There will then be a series of briefs back and forth before a court date will be set and the federal judge will actually sit down to hear both sides.

The judge at that point has one of a number of options. Those are:

1. Remand the case back to the lower court. This basically means he or she will send it back for reconsideration. Usually, the judge will do this with a directive to the agency to explore certain factors that weren’t fully weighed the last time. It’s not unusual in this scenario for the administration to simply approve the case from there. What they don’t want to see happen is a decision that is ultimately overturned by a federal judge, because it may end up setting an unfavorable precedent.
2. Affirm the administration’s decision. That means your claim is denied. In this case, your final option is to appeal the claim to the Federal Circuit Court, but you will need to understand that this is a difficult and often very expensive process.
3. Reverse the administration’s position. This means that the judge agrees with you and that you should be awarded benefits and back pay.

Continue reading

Winning a Social Security Disability Insurance benefits case takes time, organization, documentation and often an experienced Boston disability attorney.

At the end of the day, your claim will be decided based on its own merit and also how strong the argument made in your favor.

There are certain steps you can take to help improve your chances for success. There are also quite a few pitfalls to which many applicants fall prey that could prove detrimental to your case.

Every situation is going to be a bit different, but we wanted to take this opportunity to go over some of the very basic Do’s and Don’t’s to help you boost your odds.

First, let’s address some of the things that can help your claim.

Do:

• Hire an experienced disability lawyer. This is someone who is going to be with you every step of the way. He or she can handle the bulk of the paperwork, remind you of upcoming hearing dates and advise you of what kind of additional medical information could better your chances. It also means you will have one point person on which to rely, as opposed to having to deal with a bureaucratic run-around. Plus, there is no substitute for having a personal advocate in the courtroom. If you’re already coping with an illness, mounting an effective claim for disability can be a challenge. A lawyer can take care of most of the work for you.
• Find out if your doctor will be supportive of your disability case. If so, you’ll want to request that your doctor fill out a detailed statement, usually in the form of an RFC document, explaining why you are disabled and can’t work. Your attorney can make these inquiries and requests for you.
• Submit copies of your medical records and recent updates not only when you apply, but every time you appeal. Again, this is something about which your attorney can do for you.
• Keep tabs on the status of your disability case. Once more, if you have an attorney, this is something that he or she can take care of for you. Checking in allows the disability examiner to offer the suggestion that more paperwork might be needed. Calling allows the process to be expedited.
• Ask your attorney about options to have your case sped up. You may be able to submit a letter of dire need, a Congressional inquiry or an on-the-record review. Doing so won’t guarantee a faster hearing, but it may not hurt.

Now, let’s explore some of those pitfalls we mentioned earlier.

Don’t:

• Assume you aren’t able to afford a disability attorney. Most disability lawyers work on a contingency fee basis, which means we aren’t paid until you receive your benefits with back pay. The maximum an attorney can collect is 25 percent of your back-due benefits, or up to $6,000.
• Play down your symptoms or try to condense them in your initial paperwork. A lot of people do this because they don’t think examiners actually want to read through all this paperwork or because it’s a lot of work to actually fully fill out these forms. But this is the job of the examiner’s, and you have a responsibility to provide a full and accurate picture of your medical condition.
• Collecting unemployment while you wait for your claim. This isn’t always an absolute don’t, but it’s usually a bad idea. The reason is because the two benefits are based on two very different premises: One is that you are able to work, but can’t find work, and the other is that no matter how much you want to work, you are unable to do so. We understand that money is tight, but talk to your disability attorney before you move forward with collecting these benefits while you wait.
• Failing to comply with your doctor’s treatment orders. Disability examiners will be closely looking at what kinds of treatment you prescribed and the outcome of that treatment. If you failed to follow the doctor’s recommendations, that could significantly hinder your chances of being deemed disabled.

Continue reading

Administrative law judges for the Social Security Disability Insurance program have filed a federal lawsuit against the administration, alleging that they have been essentially forced to approve disability claims they otherwise would not, due to unreasonable time constraints and allegedly illegal quotas.

Our Boston Social Security Disability Insurance Attorneys can’t judge the validity of the these judge’s claims, but we can tell you with certainty that winning an SSDI claim here in Massachusetts hasn’t gotten any easier. The Social Security Administration applies a strict standard definition of disability. Failing to meet that in any capacity is going to make your claim an uphill battle – one made especially difficult if you don’t have experienced legal representation at your hearing.

Here’s what the judges are alleging:

They say that every year, they are required by the administration to oversee and decide a minimum of 500 to 700 disability claims. The agency calls this a goal, not a requirement. The judges however say that it amounts to an illegal quote that forces them to essentially decide the outcome of two or more claims each day.

They say this is an impossible benchmark when each case involves an enormous amount of complex, medical information – sometimes dating back decades.

The judges say that as a default, they’ve been deciding cases in favor of plaintiffs, mostly because doing so requires less paperwork. As the president of the Association of Administrative Law Judges was quoted as saying, approving the case in favor of the plaintiff requires a decision that is two to three pages long. However, a denial of benefits requires a more in-depth explanation, which is usually 15 to 20 pages long.

This makes sense because if you are denied benefits after investing a lot of time and energy into presenting your case, you deserve an explanation and I judge must be assured of sound reasoning.

But current and former officials with the administration have responded that this is clearly an issue of judges who simply don’t want to do their work. Michael Astrue, who served as commissioner of the agency for six years before he retired in February, said this is not the first time judges have tried to make this argument. He says they don’t want accountability, and therefore are trying to “sell this story to the media and to the Congress.”

We would argue that if the work load is in fact too high, the best solution would be to hire more judges. The only other way to pare it down would be to lessen the current per-judge goals. Without bringing on more judges to pick up that slack, we fear pending cases would take even longer to decide.

As it now stands, the administration reports the average wait time for an SSDI administrative review is more than a year. That’s 12 months of uncertainty, an inability to work and fear for what the future might bring.

Most people who apply for SSDI find themselves in this position, as the majority of initial claims are denied and must proceed through the appeals process before a judge.

Currently, the administration employs roughly 1,500 disability judges, who are spread out through all 50 states. That may seem like a fair amount, until you consider that last year alone, 3.2 million people applied for disability benefits, and that was a 25 percent increase in the number of applicants from 10 years earlier.
Continue reading